Mac Form 710 - Uniform Borrower Assistance Form Page 8

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I am requesting review of my current financial situation to determine whether I qualify for temporary or permanent mortgage loan relief
Date Hardship Began is:
I believe that my situation is:
Short-term (under 6 months)
Medium-term (6 – 12 months)
Long-term or Permanent Hardship (greater than 12 months)
I am having difficulty making my monthly payment because of reason set forth below:
(Please check the primary reason and submit required documentation demonstrating your primary hardship)
If Your Hardship is:
Then the Required Hardship Documentation is:
No hardship documentation required
Reduction in Income: a hardship that
No hardship documentation required
has caused a decrease in your income
due to circumstances outside your
control (e.g., elimination of overtime,
reduction in regular working hours, a
reduction in base pay)
Increase in Housing Expenses: a
No hardship documentation required
hardship that has caused an increase in
your housing expenses due to
circumstances outside your control
Divorce or legal separation; Separation
Divorce decree signed by the court; OR
of Borrowers unrelated by marriage,
Separation agreement signed by the court; OR
civil union or similar domestic
Current credit report evidencing divorce, separation, or non-occupying
partnership under applicable law
borrower has a different address; OR
Recorded quitclaim deed evidencing that the non-occupying Borrower or co-
Borrower has relinquished all rights to the property
Death of a borrower or death of either
Death certificate; OR
the primary or secondary wage earner
Obituary or newspaper article reporting the death
in the household
Long-term or permanent disability;
Proof of monthly insurance benefits or government assistance (if applicable); OR
Serious illness of a borrower/co-
Written statement or other documentation verifying disability or illness; OR
borrower or dependent family member
Doctor’s certificate of illness or disability; OR
Medical bills
None of the above shall require providing detailed medical information.
Disaster (natural or man-made)
Insurance claim; OR
adversely impacting the property or
Federal Emergency Management Agency grant or Small Business Administration
Borrower’s place of employment
loan; OR
Borrower or Employer property located in a federally declared disaster area
Distant employment transfer / Relocation For active duty service members: Notice of Permanent Change of Station (PCS) or
actual PCS orders.
For employment transfers/new employment:
Copy of signed offer letter or notice from employer showing transfer to a new
employment location; OR
Paystub from new employer
In addition to the above, documentation that reflects the amount of any relocation
assistance provided, if applicable (not required for those with PCS orders).
Business Failure
Tax return from the previous year (including all schedules) AND
Proof of business failure supported by one of the following:
Bankruptcy filing for the business; OR
Two months recent bank statements for the business account evidencing
cessation of business activity; OR
Most recent signed and dated quarterly or year-to-date profit and loss
Other: a hardship that is not covered
Written explanation describing the details of the hardship and relevant
Fannie Mae/Freddie Mac Form 710
Page 3 of 4
June 2014


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